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Hi Doc.. I was so happy to come across this website.  Thank you in advance for taking the time to read this.

I am 43 and have severe perio disease.  I am maintaining.  I found a "new" dentist 2 years ago and had to have tooth 13 extracted.  The "matching teeth" (#3,4 )on the other side of mouth have been splinted.  In June 2011 the dentist pulled #13 and put in bone graph and implant. All was fine.  In September he put on crown.  The next day I had excruciating facial pain and headache like pain (I am not prone to headaches)  I could barely see straight.  I called Dentist and they told me to take Ibuprofen.  I lost the filling on the tooth directly below the implant within the first few days of having implant. For the pain I went for a few sessions of cranial bodywork and the pain subsided.  She told me she had a feeling the implant was going to have to come out, that my mouth/bite was not balanced and it was going to throw my whole body off.  Over the next year and a half my face become "numb" on my left side.. going down my neck and left arm.  I felt like I was punched in the nose... that numbing hurting feeling.  sometimes the pain was blinding going up the left side of my face.  My left ear bothered me. I called my dentist numerous times and explained the pain. They put me on antibiotics a few times for perio.  Then it felt like #10 was moving (I call it my snaggle tooth) they said it was due to my perio issues and that my teeth were shifting. I was in their office every 3 months for my cleanings.  The doc said everything looked fine.  I said it felt like the implant was too big... too tight. he "filed" it inbetween the teeth... always telling me it was fine.  This May (2013) the pain became so bad that I couldn't drive.  I couldn't see straight.  I have no depth perception.  I was having anxiety attacks.  Worst is I couldn't drive to work. Driving became dangerous for me.  I told my dentist I was going for second opinion.  His office told me make sure new dentist doesn't touch implant or my 5 year warranty will be void.  I went to another dentist close by for a second opinion, he thought maybe there was some glue stuck up in there causing infection.  He did panoramic and everything looked fine.  I went back to my doc and told him what the other dentist said about the glue, maybe I need to be opened up and cleaned, other dentist said glue doesn't show up on scans or xrays.. and my dentist really just blew me off. They gave me another round of antibiotics and I felt better, but then all symptoms came back.

Memorial weekend I felt so bad I went to ER and that doc said I had trigeminal nerve damage and to go to neurologist. I called dentist office and one of the assistants thought maybe I was having phantom pain.  I told her ER doc said trigeminal.. she said that doesn't normally happen on the upper.  Then told me to go get an MRI. Then denied telling me to get an MRI...  I told my dentist I was going to get another opinion from a dentist that has a 3D scan.  They said come here.. we have that too... Im sure you can understand I was feeling like ?huh? ...why didn't you offer it to me before??? 3rd dentist did 3d and could see the implant was "ailing", not failing, YET.  It had penetrated thru part of the bone. He explained he does not usually recommend taking implants out, but in this case it was only going to be a matter of time before it came out.  Implant was removed July 2.  (it was a horrid experience)  I took amoxicillin, and ibuprofen.  I felt good other than the soreness which is to be expected.  Now I'm back to feeling dizzy again.  vision is not right. earache. like i'm not inside my body.  this feeling goes from forehead to leftside of face to ear down neck and arm.  I had MRI and everything looks fine.  Neurologist says I have trigeminal nerve damage variant and I could either take meds or try body work (cranial sacral)(its helping) but either way neurologist wants me to see ENT.  ENT said they have never heard of trigeminal nerve issues coming to them and doesn't want to see me.  They told me to get second opinion from another neurologist. Cranial person says its inflammation in my nerves. The type of dentistry performed on me puts a lot of stress on nerves and body. I have changed my diet dramatically to try and reduce inflammation and am taking supplements.  It's helping.  But most days I still cant drive.  I m going to loose my job if I don't figure out what's wrong with me.  Please help.  Any thoughts on were I should go for help would be so appreciated.
In case I missed any, here are symptoms: headache, earache, nausea, dizziness, (not spinning, just dizzy like coming off a rollercoaster) unbalanced, anxious, numbness in face, nose, neck and arm. excessive sweating, ear feels hot.  implant had always hurt or felt too tight in my mouth. since its out, it no longer "hurts", but face and nose are numb/feels like I was bumped in the nose.

Thank you!

Answer
Jennifer -  What you are enduring is not uncommon.  Unfortunately, many dentists are not skilled and objective in understanding the cause of the type of pain you have.  You symptoms of headache, earache, nausea and dizziness  are often caused by the loss of teeth and a change in the bite.  With this change, the jaw muscles are often called upon to work differently and from different positions with stretching.  The jaw muscles go into spasm.  Just like a "Charlie horse" problem in the calf muscle, this problem can produce a lot of pain.  It does not disappear as easily as a different muscle because every time we bite down and swallow we are aggrevating the muscles and exaggerating the spasms of the muscles that are already present.  

Now comes the difficult part.  Finding a skilled dentist who will know how to regain a stable bite to relax the muscles.  Temporarily you might need a mouth guard, muscle relaxers and warm moist treatments to relax the muscles.  I suggest that you make an appointment with a board certified oral and maxillofacial surgeon in your area.  In the interim, to relax the muscles and reduce the pain, you need to immediately begin a strict, but simple regimen.  Start warm salt water rinses for about 5 minutes, 4-5 times a day.  The rinses need to towards the back of the jaw on both sides, where the muscles attach.  

So find a surgeon.  Start the rinses until you make the appointment.  You should notice a reduction of pain with the warm salt water, but it may not get better until 4-5 days.  Please get back to me and let me know how you are doing.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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